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Chemical Fire – Nursing Home Evacuation

Wake County

North Carolina

2006

On October 5, 2006, a fire at the Environmental Quality Company in Apex released a dangerous chemical plume into the air. The Apex Fire Department and Apex Emergency Medical Services (EMS) participated in unified command together with Wake County Emergency Management, Wake County Emergency Medical Services, and other agencies.

Residents in the path of the chemical plume were asked to evacuate, and as the winds shifted, it became necessary to evacuate a nearby nursing home as well. Wake County and Apex EMS evacuated approximately 100 nursing home residents during a 4-hour period in the late evening and early morning.

The response was a success, but several lessons were learned that have led to improved planning since the event. First, it is critical to identify multiple methods of transporting wheelchair-bound or bedridden patients prior to an event and to maintain an up-to-date list of transportation resources, including staff to move patients and drive vehicles. During the evacuation, it took 3-10 minutes to load a single wheelchair into a transit bus with a wheelchair lift and ambulances transported only one patient at a time.

It is also important for all nursing facilities to have a functional evacuation plan, including pre-identified sites for relocating patients, and to conduct regular training using the plan. If possible, residents of congregate living facilities should have a "go pack" with clothing, personal items, and lists of medical conditions, equipment, medications, and dietary needs.

Since 2006, Wake County and the Town of Apex have continued to improve planning for at-risk groups. Wake County will soon acquire a specially equipped medical evacuation bus that will be used for similar events in the future. Currently, advanced practice paramedics are working with congregate-living facilities on emergency planning.